Advice

Welcome!

I hope each of you takes a moment to breathe, take pride in your accomplishments, and to thank those who have helped you to achieve them. You have earned your place in this class, you absolutely deserve to be here, and we are so glad you are here! I have had the privilege of teaching, mentoring, advising, and supporting medical students and residents for over 20 years now — it has been one of the greatest joys of my life and the focus of my career.

Here are a few things to consider as you progress through medical school and the rest of your career as a physician:

Reflect on what you enjoy and what you don’t enjoy. When you have a really great day, ask yourself what made it great and why? When you have a bad day ask the same. Look for patterns so that you can know what things really motivate you and will keep you happy and engaged in your career for the next 50 years — yes, it likely will be that long. Your coaches and coaching groups will be helpful partners as you reflect on these things to choose your next steps.

Learn about the different specialties and what the day-to-day work in those careers is like. Often, we come to medical school with fixed assumptions about what we want to be or what specific careers are all about. Try to push those biases aside and really experience it and what it would be like for you if you were doing that work. Talk to people about their jobs, what they love about them, what they like less. See how much those things align with your own self-realizations about your passions and interests.

Take care of yourself. Each person has different things they need to be well — exercise, time with friends, reading for pleasure, cooking, etc. For me it’s exercise and time with family that really ground me. Figure out what yours are and prioritize them. You will struggle to perform well if you are not well. You will benefit from these habits and patterns for the rest of your career.

Get to know your patients. We can become wrapped up in only learning the medicine, but our patients have amazing personal stories and those stories help us understand who they are and what they really care about. These stories help us tailor their care in partnership with them and their priorities. Moreover, when patients feel seen and heard, they experience better care.

Get to know each other, the other students on campus, the residents and fellows you work with, and the faculty. You are part of an amazing community of people who care deeply about your education and your interests, but also about you as a person. Many of these folks will become your lifelong friends and colleagues.

Ask for help when you need it. We have a variety of resources from peer advisors, to the Medical Student Government, to Student Affairs and the Student Success Team, the ombuds office, Dr. Winters and Student Health Services, and, of course, your administration, faculty, and peers. We are all here to support you!

Finally, enjoy the ride. You will work hard — likely harder than you have ever worked in your life. You will see and experience things that are unfair and unjust. You will have the privilege to share some of the happiest and saddest moments of your patients’ lives. You will learn more than you ever thought possible. And, you will serve others and feel the joy that only a career of service can bring. Ultimately, you will help to make the world a better place. What could be better than that?

Choosing a specialty within clinical medicine is one of those fundamental questions tied to your identity as a medical student. Your parents want to know, your residents and attendings will want to know, and you want to know for yourself what you’ll spend the next 20-30 years doing day in and day out!

First, let’s remind ourselves that life is long and flexible. Even once you commit to a specialty field, you will have flexibility to take on additional fellowships or different jobs to practice aspects you love and avoid parts you find tedious. With that said, here is a relatively simple algorithm to follow: Do you like surgery or medicine? Now, you can go forth and explore the various subspecialties within general surgery and surgical subspecialties (neurosurgery, orthopedics, plastics, urology, otolaryngology, ophthalmology, etc.) or in medicine and pediatrics (allergy, rheumatology, cardiology, gastroenterology, hematology/oncology, etc). For example, if the OR is your favorite place in the hospital (but not in the world), choose anesthesiology. If you like cerebral medicine but don’t like patient contact, consider radiology or pathology. If you like a bit of everything, consider internal or family medicine. Women’s health plus surgery? Obstetrics and gynecology. And once you’ve narrowed down your choices to similar subfields, you should consider lifestyle and financial aspects of a typical practitioner within those fields to differentiate.

I came into medical school knowing I was most interested in surgical care, started research in a niche-surgical specialty subfield to give myself options in the future, did rotations in almost all the subspecialties, and came down to two similar choices. Ultimately, I chose a field whose people I most enjoyed spending time with and that gave me the most flexibility in future types of fellowships, practices, and lifestyles that I could accommodate alongside my non-medical interests. At the end of the day, being around people you enjoy, patients who appreciate your care as much as you appreciate them, and clinical experiences that make time fly by, will keep you uplifted.

-Kwasi E., M4

I started medical school thinking that I would go into psychiatry or orthopedic surgery. I started shadowing both to get a better feel for the specialties and knew that I would get even more exposure during clerkships. Now that I’m in my fourth year, I’m applying into emergency medicine. Picking a specialty can be a challenging process, and it’s important to not rush through it. My advice would be to think about the day-to-day in a given field, not just about the most exciting parts. For me, there was a lot to love about both psychiatry and orthopedic surgery, but the day-to-day of emergency medicine had me waking up even more excited to go into the hospital. I’ve found that the actual experience of rotating with a certain specialty can feel vastly different than what you might imagine, so make sure to rotate through as many services as you can. There are always rotations that you will enjoy far more than expected and rotations you enjoy far less than you imagined. Lastly, I find it helpful to write about my experience on each rotation both during it and immediately afterwards. It’ll be helpful to reflect on months later when you’re looking to make your final decision.

-Justin Y., M4

Medical school is an exciting time and can be all-encompassing. But you need a break. I suggest finding something else that really takes your mind away from it. It should be something you can do regularly without too much planning. Ideally the “something else” gives you real pleasure. When you are doing the “something else” you need to let yourself be fully present to enjoy the activity. This can be harder than it sounds. For me, the things that work are swimming and ice skating. I’m not too skilled at either one, but every time I swim or skate, I always take a moment to reflect on how happy I feel getting to do something I love. I never regret the time I have spent on these activities when I get back to work.

Being a physician is an incredible and humbling experience. You will be invited into the most intimate moments of life with people you may have never met, but whom you will never forget, and who will certainly never forget you. You will become an integral part of their life stories, forever entwined in their most life-changing moments. It’s quite a privilege, and it comes with responsibility that can seem overwhelming at times. With that in mind, my two biggest pieces of advice as you embark on this journey are to invest in relationships and to take care of yourself.

Relationships are essential to the practice of medicine. The relationships you develop with patients, peers, faculty, and other colleagues will impact the care you are able to provide. These relationships — along with those in your personal life — will also help keep you balanced and bring meaning to your work. In every interaction, pause to think about what biases you may have and how you can mitigate their impact, what barriers to care may exist and how you can help overcome them, and above all — remember the person inside each patient, caretaker, and colleague. When we’re tired or stressed, it’s easy to forget that they all have their own stories, but one of the most important things we can do as a physician is to ensure that people feel heard and cared for. Remember the wise words of St. Louisan Maya Angelou: “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

In addition to investing in relationships, take care of yourself in other ways — physically, emotionally, and spiritually. There’s a reason they tell you on airplanes to put your own oxygen mask on before helping others; if you aren’t taking care of yourself, you won’t be able to take care of anyone else. So be yourself and make time for what matters to you, whatever that may be. Give yourself grace when things are hard, and ask for help when you need it. There are so many people at WashU Med who truly care about you as a person and want to support you however we can. Remember what motivated you to attend medical school, and keep your eye on your long-term goals. As you experience different specialties and career paths, reflect on what brings you joy, what energizes you, what it is that makes you excited to get out of bed in the morning — because a career becomes a calling if it’s your heart’s work.

Finally, remember that nobody knows everything; being a physician means committing to lifelong learning. So never stop learning — about science, medicine, cutting edge technologies … about life, death, joy, grief, hope … about what it means to be human and to share the human experience with others. I look forward to accompanying you on this exhilarating journey.

Welcome, class!

It is a pleasure to have this opportunity to connect with you. I hope you are as excited about getting started as we are to begin another year.

Other contributors on this page have shared many valuable insights and lessons learned. I agree with it all but want to share a few things that have shaped my own path and academic priorities. I was an MSTP student and have always been excited by science, and particularly biology. For me, medical school was transformative. I had the opportunity to take deep, and often independent, dives into human biology, the mechanisms of disease, and investigation. I loved it, and it was these experiences that led me first to pathology and independent research, eventually to laboratory management, and increasingly to medical education.

Regardless of your current goals, it is important to find and follow your passions, and when special opportunities present themselves, to also explore new ones and evolve. Nearly every physician will confide that medical school provided the best opportunities to do that exploration. It is an unfortunate reality that you will probably never find a better time. Demands of work and life will inevitably pull you in many directions. The broader the foundation you build today and the more learning skills you master, the easier it will be to succeed in your career, whether as a physician, scientist, educator, and/or advocate.

As faculty, we spend more time than you can imagine trying to create a curriculum that will prepare you for your future careers in medicine. Although it is important to achieve the stated educational objectives, it is just the beginning. There is just too much out there and so many new and important things to learn. Plan to take full advantage of the unique opportunities that Gateway will bring to you.

If you would like some assistance, just seek us out. We are always here for you.

Happy learning, happy exploring … 

Even before entering your first class and donning your first white coat, I’m sure you’ve already been asked, “So, what kind of doctor are you going to be?” You will likely be asked this every time someone learns you are a medical student. I would challenge you to think of that question differently than typically intended — not what specialty you will pursue but how you will doctor, what patients you will serve, and what attributes you will bring to the practice of medicine. One key way to do this is to keep an open mind in every lecture, patient interaction, and clinical encounter. Even if you are 100% certain you will pursue orthopedic surgery or pediatrics or dermatology, I promise you can learn something unexpected from patients, peers, and faculty in every other specialty you work in. These small nuggets will give you a richer foundation for your future career in medicine. And, you may even find many other specialties you are excited to explore. (It’s actually amazing to love multiple specialties and have the freedom to choose among multiple career options!) 

As a program director, I’m often asked — even by M1s! — how to build a strong residency application. My advice is to put residency applications out of your mind for as long as possible. Trust me, I know that’s hard! I would challenge you to look at medical school not as the time to build your application for residency but rather as the place to develop the foundation to serve as a physician in whatever capacity is most meaningful to you. Remember that a career in medicine is not limited to the clinical practice of a specific specialty. Many physicians (including almost all of those you will work with throughout the next four years and beyond) have multi-faceted careers where, in addition to patient care, they engage in research, advocacy, education, or policy (or several of these!). Pursue the activities and experiences that you find personally and professionally fulfilling — regardless of what specialty they may be attached to. Your journey through medical school should be unique and incredibly personal to your own story, aspirations, and mission. And believe me, if you forge your own path founded on your passions and values, that will shine through when you’re ready to apply for residency. Most importantly, you will be well on your way to crafting a meaningful and fulfilling career that will last well beyond your residency training. Enjoy this time and make the most of it.

The “reminiscence bump” is a psychological phenomenon where older adults preferentially remember autobiographical information from adolescence and early adulthood. Researchers think this is because these memories contribute most to one’s sense of self. You are now (most likely) at an age that you’ll remember for the rest of your life. Most physicians (this one included) would tell you that their profession is a part of their identity. And your process of becoming a physician starts now. Like it or not, these are the times of your life you’ll look back on often.

That said, my advice is that medical school probably matters less than you think it does. “Being a doctor” will only be a part of your identity. Don’t let yourself believe that your success is solely based on what and how you do in school for the next four-plus years. Don’t forget to focus on life outside of the classrooms, hospitals, clinics, and studying, so that you can have experiences that you’ll want to remember.

Think for a minute about all it took for you to be here starting medical school at WashU Med: where you came from, the people supporting you, your hard work and commitment to others, sweating the MCAT, capitalizing on what makes you you, crying in organic chemistry lab because you discarded the solution and not the precipitate (don’t pretend that was just me). Each of your classmates had an equally as interesting journey to medical school. The same is true of all your instructors. Even more so, your patients all live interesting lives, and are a part of amazing communities. One awesome privilege you’ll have as a medical student is meeting and developing relationships with people that you wouldn’t have otherwise. Learn from them all. Let them pull you outside of your comfort zone. Be curious. Share yourself with others. The work of medicine will cause you to grow as a person. Let your experiences outside of medicine do the same. Those two things aren’t mutually exclusive. Have fun. The future of your memories depends on it.

You will spend the next four-plus years at WashU Med with your peers, and they will be your lifelong friends and colleagues. Form strong bonds with your classmates, collaborate, and support each other. Get to know the faculty, administration, and staff. We are here to help you succeed. Find an advisor or mentor who takes an interest in you. Your mentor will help you navigate medical school, and if you’re lucky, you may get a home-cooked meal out of it. Stay grounded by volunteering in the community. Have fun and stay healthy by getting involved in school clubs and continuing with your hobbies. Get to know St. Louis; there is no shortage of entertainment, including the world-champion Cardinals and Blues, the world-famous Saint Louis Zoo, the Saint Louis Science Center, the Saint Louis Art Museum, and the Missouri Botanical Garden. In addition, there is a world-class symphony, many music venues, and plenty of nightlife. Pay attention to your academics. Take your basic science courses seriously. They will come in handy in later years, and your future patients will thank you. Don’t worry about your residency match yet. Most importantly, get enough sleep, exercise, and have fun. Oh, and if you want to do research, just email me (chungk@wustl.edu).

Visit Dr. Chung for guidance on research opportunities and to ask her about her favorite rapper. (Hint: He’s slim, and he’s shady.)

Congratulations on beginning your career in medicine! The volume of medical knowledge and vast complexity of skills that a physician needs to master can feel overwhelming for a new student. After 20 years of practice, I find that I am still learning every day. Some of this stems from the rapid changes occurring in medicine every year as we learn more about disease processes and discover better ways to care for our patients. It also comes from the wonderful environment that the WashU Med community provides for all of us to learn in. This is a place of discovery and innovation where our physicians and scientists are leading the research and development important for the future of medicine. It is a place where teachers and mentors patiently guide students and residents through their education. And finally, it is a place where everyone is empowered to ask questions with the intention of providing better care for our patients. I encourage all of my students to challenge me and ask me why. As you ask questions to seek to understand my clinical reasoning surrounding a case or understand the foundational principles underlying a patient’s condition, you are contributing to this community of learning and culture of growth. Medicine will continue to evolve and the pace of change will very likely accelerate over the course of your career, so developing a mindset open to learning and improvement will be a critical skill.

During your time in medical school, embrace all of the learning opportunities. You may not see yourself pursuing a specific field in medicine, but take the time now to learn all that you can learn about it. Run towards opportunities to practice skills or to try new things. Don’t worry about being wrong or failing, but rather be open to feedback so that you can learn to do it successfully the next time. Remember that you can learn from anyone in the clinical environment; value the pearls of wisdom and seek feedback from health care professionals who are not physicians. Finally, take a moment every day to reflect on a small accomplishment along your path to becoming a physician to remind yourself that you are capable of reaching your goal at the end of the long journey.

Welcome to WashU Med! My name is Tim Yau, and I am one of your clinical skills directors for the Gateway Curriculum. Our team is here to teach you all the “non-science” stuff that is necessary to becoming a great physician.

The qualities that will make each of you outstanding doctors is so much more than test scores, which all of you already are capable of. We’ll teach you all the things you expect — how to talk with and examine patients, how to formulate diagnoses, how to interpret labs and tests. But you will also learn how to see your patients as individuals, how to involve them in patient-centered decisions, and how to navigate the complicated societal and structural barriers to their health. The amount of information you will learn in the next four years is both staggering and intimidating. Your learning will not end with medical school, and we hope to light a fire for you to never stop learning!

During medical school you will have opportunities over the next four years to do things that you may never again do in your lifetime. I am a kidney specialist, but I still delivered plenty of babies as a third-year medical student! Learn for the sake of learning (rather than just to pass the test) and you will find the pursuit of knowledge more worthwhile, more meaningful, and longer lasting. Your individual path to fulfill your potential to be a great doctor will be decided by you. Faculty like myself are your mentors, role models, guides, and colleagues in this journey.

Lastly, we hope you are eager to learn, but also want you to ENJOY your medical school experience. Some of the strongest bonds are forged here, and you will need support from family, old friends, and the new friends you will make. Get outside, eat some good food, and have a drink to relax. Take time to enjoy things that make you happy, whatever they are! This advice sounds generic, but I live by my own words: Playing music kept me happy during medical school, and even now at the age of 40+ I enjoy competitive video gaming. In 2018, we even started the official WashU Med Gaming Club! I have instruments and consoles in my office, and you’re welcome to stop by for a game or to play a tune!

It’s exciting to be a first-year medical student! You will learn how the human body works in detail, from head to toe, from gross anatomy to subatomic structures. However, some of the current concepts and “facts” you will learn will prove to be wrong. That’s right (actually still wrong!). It’s not that you’re being deliberately taught misinformation. It’s just that we don’t know our own ignorance (yet). Keep in mind, what you’re learning is how we understand things, circa 2024. But we don’t know what we don’t know.

While it is certainly much easier to learn the materials if you just try to absorb it verbatim, my advice is to spend some time thinking about what you’re learning. I can now reflect on the lectures I heard as a medical student touting that the cause of peptic ulcer disease was too much acid. In retrospect, that couldn’t be right because acid is always there! I didn’t think about it then, but I should have, because now we know (I think pretty conclusively) that ulcers are often caused by a bacterial infection! Keep track of things that don’t make sense to you along with those that are incompletely understood (there are lots of them!). For aspiring scientists, they will be great projects on which to work in the future. For future clinicians, they will be the ones that you will reflect on, and cause you to go back over your old medical school texts and notes — if not when you’re practicing, certainly a great retirement project!